ACL injury | Dr.Rewat Laxman
What is ACL ligament?
The ligament present in the center of our knee is known as Anterior Cruciate Ligament or ACL. There are 4 major ligaments hold the knee together, and the ACL is one among them. The ACL is damaged when it is injured or twisted. It is the site for one of the most common injuries of the knee. Half of the ACL injuries (knee injury) happen along with rupture of the other knee structures like cartilage, meniscus, and ligament. The ligament injuries are called as sprains and are widely categorized into three grades:
Grade-1 Sprain: Ligament is damaged slightly and stretched but retains the ability to keep the knee stable.
Grade-2 Sprain: The ligament is stretched to the level of loosening, referred as a partial tear of the ligament.
Grade-3 Sprain: The ligament is completely torn into two parts, making the knee joint unstable.
What is the common causes ACL injury?
Here are some of the common causes of anterior crucial ligament injury
- The rapid change of direction
- Stop suddenly
- Slow down during running
- Incorrect landing from a jump
- Direct contact with tackling in football
According to many researchers, female athletes are more prone to ACL injury compared to the males. The experts say that it is due to the difference in the structural integrity of muscular strengths, neuromuscular control, and physical conditioning. The differences in the lower extremities and pelvis may also contribute to the ACL injury.
What are the symptoms of ACL injury?
The following possible symptoms when you injure your ACL ligament
- ‘Popping’ sound from your knee
- Your knee cannot bear the strain from your weight
- Swelling within 24 hours
If you have a knee injury and notice the symptoms mentioned above, it’s important to visit your Doctor. Even though you observe that swelling may reduce on its own by taking rest, the moment you resume any serious activity, exercise or any sports, the swelling and pain would reoccur. If it’s left untreated, ACL tear might also lead to damage to the cartilage in your knee joint.
You might hear a “popping” noise and may feel your knee give out from under you When the ACL is injured. Other typical symptoms include:
- Impact on even a simple motion
- Pain in the joint
- Difficulty in walking
How to diagnose an ACL injury?
The anterior crucial ligament injury can be diagnosed in the following ways:
Physical Examination/Medical History:
When you meet your doctor, a physical examination is performed to check the symptoms, movement, and structure of the injured knee. A comparison is done with the good knee, and medical history is taken.
Some of the major diagnostic tools used are,
- X-rays: It is suggested to rule out if any broken bone is associated with the injury.
- MRI (magnetic resonance imaging) Scan: MRI gives the clear image of the structures of the soft tissues like ACL.
What are the treatments?
ACL injuries treatment depends on patient’s requirement. Non-surgical and surgical treatments both are available for anterior cruciate ligament injury. A patient with high demands of the knee, or who is active in sports or athlete, would require surgery. The older aged patients, who are less active, can get back to their usual lifestyle without any surgical procedure.
The doctors generally suggest simple treatment if the overall stability of the joint is fine. Some of the non-surgical options are:
Non Surgical Treatments benefit elderly patients who have a low activity level of the knee. The doctors generally suggest simple treatment if the overall stability of the joint is good. Some of the non-surgical options are:
- Bracing: Bracing is good to guard the instability of your knee. For better protection, further, your doctor may give you crutches for a few days to stay the burden off your leg.
- Physiotherapy: Once the swelling begins to reduce, a rehabilitation program under expert’s supervision should be started carefully. This helps to bring back energy and strengthen the knee muscles.
According to a research article published in the Journal “Operative Techniques in Sports Medicine”, a surgeon should take care of some basic steps before and while performing an ACL reconstruction which includes pre-operative evaluation, selection of the patient, techniques of the procedure and rehabilitation methods. This is known to achieve the expected outcome after the surgery.
There are several types of surgical treatment options available for arthroscopies, like patellar tendon graft procedure, Hamstring graft procedure, Allograft procedure, and ACL reconstruction. However arthroscopic ACL reconstruction is the most suited process for most of the patient’s condition.
Arthroscopic anterior cruciate ligament reconstruction:
ACL reconstruction is done to treat the damaged or ruptured anterior cruciate ligament of the knee. It is done to replace the damaged ACL ligament by an artificial or self-tissue graft.
Doctors suggest ACL Reconstruction for the patients who have a high risk of further damage. This procedure is carried out either as an open surgery or using an arthroscopic approach.
According to the Journal named “Operative Techniques in Orthopedics”, during ACL reconstruction, pay lots of attention to the points like graft harvest, hole preparation or notch to avoid complications, and to make sure that a full range of motion and knee stability is obtained.